ESMO E-Learning: Advances in Gastric Cancer: Biology and Treatment for Advanced Disease

Learning Objectives

  • To learn about molecular classification of gastric adenocarcinoma
  • To provide an update on first- and second-line treatments in patients with advanced gastric cancer
  • To provide an update on currently available and emerging targeted agents, as well as advances in immunotherapy approaches tested in patients with advanced gastric cancer

After two years E-Learning modules are no longer considered current. There is therefore no CME test associated with this E-Learning module.

Title Duration Content CME Points CME Test
Advances in Gastric Cancer: Biology and Treatment for Advanced Disease 63 min. 64 slides 1 Take Test
Andrés Cervantes
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The module is divided into chapters on molecular classification, treatment options for advanced gastric cancer, targeted therapies and immunotherapy advances.

Although of paramount importance, molecular classification is not ready yet for the clinic. In the present module, the author reviews the pathology classification of gastric adenocarcinoma, molecular subtypes after gene expression analysis, molecular platforms and comprehensive molecular characterisation of gastric adenocarcinoma, as well as molecular differences between Asian and Western patients.

Furthermore, the author reviews first- and second-line chemotherapy options and the progresses made in the treatment of patients with advanced gastric cancer. He continues by reviewing the targeted agents. Most targeted therapies have failed in molecularly unselected trials.

HER2 status should be determined in all patients with advanced gastric cancer and trastuzumab should be added to chemotherapy in HER2-positive disease. Platinum-based chemotherapy represents the first treatment option, with FOLFIRI regimen as an alternative. Second-line chemotherapy prolongs survival in patients with good performance status. Ramucirumab as single agent prolongs survival versus best supportive care. In combination with paclitaxel , ramucirumab improves outcomes over paclitaxel alone.

Upon reviewing the clinical studies and indications for monoclonal antibodies, the module provides an update on immunotherapy (mainly pembrolizumab) currently under development with interesting data to be confirmed.

The author advocates for a better selection of patients in clinical trials, validation of molecular classification in trials and international cooperation.

This E-Learning module was published in 2015 and expired in 2017.

Last update: 02 July 2015

The author is a member of the speaker’s bureau for Roche and Merck Serono. He has participated in advisory boards for Merck Serono, Roche, Amgen, Bayer and Lilly.